One of my patients recently asked me ‘What is this BAAPS malarkey? What’s special about a BAAPS surgeon?’ She had researched cosmetic surgery online and read that it was important to check that your surgeon is a member of BAAPS and/or BAPRAS.
She visited several cosmetic surgery clinics prior to our consultation and had been told by a salesperson at a well-known company that ‘Our surgeons are cosmetic surgeons and don’t need to be members of BAAPS and/or BAPRAS’ and that ‘Anyone can be a member, they only need to pay the fees’. It is shocking that the public are being so willfully misinformed by some companies in order to close a sale.
Accreditation is not merely a membership of a club. The standards required in becoming an accredited member of BAAPS and/or BAPRAS are exceptionally high, requiring training, examinations, on-going practice and annual auditing well above the levels required by non-accredited surgeons. At Sthetix, all our surgeons are fully accredited to the highest possible standards within the industry.
Mr Rizwan Alvi
Sthetix Consultant Plastic Surgeon
Finally, the long-awaited report on the provision of cosmetic surgery has been published. The Keogh report addresses the issues related to cosmetic surgery and non-surgical treatments. We, at Sthetix clinic in Liverpool, are fully supportive of the recommendations of this report.
Over the last 9 months, Medical Director of the NHS (Professor Sir Bruce Keogh) has been undertaking a critical review into all aspects of the cosmetic industry. His committee’s findings were released today (24th April 2013) in the form of a report outlining the lack of regulation and risks involved of patients seeking treatment from unqualified practitioners.
Not only do we endorse the recommendations of the report, at Sthetix Cosmetic Surgery Clinic Liverpool, our practice exceeds the standards required by the regulations. We are an independent centre of excellence based in Liverpool following the ethical guidelines set out by BAAPS and the GMC.
The key recommendations of the report are set out below, together with our comments:
- The scope of the EU Medical Devices Directive should be extended to include all cosmetic implants including dermal fillers, UK legislation should be introduced to enact the changes sooner. Legislation should be introduced to classify fillers as a prescription-only medical device.
At Sthetix, all of our non-surgical cosmetic treatments are performed exclusively by fully qualified Consultant Plastic surgeons, members of BAAPS and/or BAPRAS.
- The Royal College of Surgeons (RCS) should establish an Interspecialty Committee on Cosmetic Surgery, made up of representatives of all the relevant specialty and professional associations. The purpose of this group is to set standards for cosmetic surgery practice and training, and make arrangements for formal certification of all surgeons regarded as competent to undertake cosmetic procedures, taking account of training and experience.
At Sthetix Cosmetic Surgery Clinic Liverpool, our consultants are responsible for the teaching and training of junior surgeons, both in reconstructive plastic surgery and cosmetic treatments.
- All those performing cosmetic interventions must be registered.
At Sthetix, our Consultant Plastic surgeons are locally based, are all on the GMC Specialist Register and are members of BAAPS and/or BAPRAS.
• Surgical providers should provide both the person undergoing a procedure and their GP with proper records.
As standard, with any cosmetic procedure, we inform our patient’s GPs before commencing any treatment, as well as providing them with the relevant information once a treatment is undertaken. All patients with implants are given a record of what their implant was, as well as keeping the records ourselves.
- A breast implant registry should be established within the next 12 months and extended to other cosmetic devices as soon as possible, to provide better monitoring of patient outcomes and device safety.
Despite there not being a national database already implemented, at Sthetix, as standard practice, we keep a full record of all implants we have ever used as well as all non-surgical medical devices (including dermal fillers).
Many other practices don’t follow a rigorous consenting procedure, which means their patients leave uninformed and often having made rushed decisions. I, however, believe in the importance of ensuring that the risks and complications of any procedure are fully understood as well as the benefits, before any decision is taken.
Mr Irfan Khan
Sthetix Consultant Plastic Surgeon
- The RCS Interspecialty Committee on Cosmetic Surgery should develop and describe a multi-stage consent process for operations. Consent must be taken by the surgeon performing the operation to ensure that the patient and practitioner have a shared understanding of the desired outcome and the limitations, implications and risks of the procedure.
At Sthetix, we believe that informed consent of the patient is the most important aspect of a consultation, and as a result, we insist on patients having a minimum of 2 separate consultations for all surgical procedures. In the first consultation, we ensure that all of the relevant information is given to the patient and they have the time needed to ask any questions they might have.
After a cooling-off period, where patients may have more questions, we encourage them to write them down to discuss them in their second consultation. The consenting process is only ever completed by the surgeon performing the procedure, where they will ensure that the patient’s expectations are realistic, as well as ensuring that all of the risks and potential complications are fully understood, and ensure that all questions the patient might have are fully answered before agreeing to proceed.
- Evidence-based standardised patient information should be developed by the RCS Interspecialty Committee on Cosmetic Surgery, with input from patient organisations.
We pride ourselves on giving the most up-to-date information based on current evidence to patients during the consultation and ensure that the relevant information is understood completely before agreeing to proceed.
I agree with the report’s criticism of the lack of regulation of medical lasers. Currently, anyone is permitted to use a medical laser for cosmetic treatments, including hair removal. Medical lasers are powerful pieces of equipment, and in the wrong hands, are capable of disastrous results. We would welcome compulsory minimum standards of qualification well above current levels.
Mr Hassan Shaaban
Sthetix Consultant Plastic Surgeon, Laser Specialist:
- For non-surgical procedures a record of consent must be held by the provider.
At Sthetix, any cosmetic treatment, including all non-surgical treatments requires the same rigorous standard of informed consent to ensure that the patient is aware of all risks and complications, but also has a measure of the limitations of the procedure, before they proceed with a treatment.
- Existing advertising recommendations and restrictions should be updated and better enforced.
- The use of financial inducements and time-limited deals to promote cosmetic interventions should be prohibited to avoid inappropriate influencing of vulnerable consumers.
As members of BAAPS, our surgeons and the clinic as a whole follow and strive to exceed their guidelines, in which advertising to patients, giving time-limited discounts and pressure sales tactics are all considered unacceptable. We believe that elective surgery is one of the most serious decisions that can be taken by a patient and that there should be no external forces in influencing that decision. The patient’s free choice is key.
- All individuals performing cosmetic procedures must possess adequate professional indemnity cover that is commensurate with the type of operations being performed. For surgeons working in this country, but who are insured abroad, indemnity insurance must be commensurate with similar UK policies.
At Sthetix, our Consultant Plastic surgeons are locally based, and are all on the GMC Specialist Register, and are fully insured with UK- based medical specialty insurance companies as well as being members of BAAPS and/or BAPRAS.
The issues outlined in this report have long been a concern for ethically practicing, fully qualified Consultant Plastic Surgeons. At Sthetix, we welcome the report’s findings and now hope that the Department of Health will move quickly to implement and enforce these recommendations.